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Differential diagno...
Differential diagnosis of solid pancreatic masses: contrast-enhanced harmonic (CEH-EUS), quantitative-elastography (QE-EUS), or both?
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Iglesias-Garcia, J. (författare)
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- Lindkvist, Björn (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin,Institute of Medicine
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Larino-Noia, J. (författare)
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Abdulkader-Nallib, I. (författare)
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Dominguez-Munoz, J. E. (författare)
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(creator_code:org_t)
- 2017-03
- 2017
- Engelska.
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Ingår i: United European Gastroenterology Journal. - : Wiley. - 2050-6406 .- 2050-6414. ; 5:2, s. 236-246
- Relaterad länk:
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https://journals.sag...
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https://gup.ub.gu.se...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Background: Contrast-enhanced harmonic endoscopic ultrasound (CEH-EUS) and quantitative-elastography endoscopic ultrasound (QE-EUS) are considered useful tools for the evaluation of solid pancreatic tumors (SPT). The aim of our study was to evaluate the diagnostic accuracy of CEH-EUS, QE-EUS, and the combination of both for the differential diagnosis of SPT. Methods: Sixty-two consecutive patients (mean age 64.3 years, range 32-89 years, 44 male) who underwent EUS for the evaluation of SPT were prospectively included. EUS was performed with a linear Pentax-EUS and a Hitachi-Preirus processor. The mass (area A) and a reference area B were selected during QE-EUS, and results expressed as B/A (strain ratio). A strain histogram of the mass was also evaluated. Microvascularization of the tumor was evaluated over 2min during CEH-EUS after intravenous injection of 4.8mL SonoVue. Final diagnosis was based on histopathology of surgical specimens or EUS-guided tissue acquisition and clinical follow-up in non-operated cases. Diagnostic accuracy of CEH-EUS, QE-EUS, and their combination was calculated. Results: Median size of the masses was 32 mm (range 12-111). Final diagnosis was pancreatic adenocarcinoma (n=45), neuroendocrine tumor (n=3), inflammatory mass (n=10), pancreatic metastasis (n=2), autoimmune pancreatitis (n=1), and a mucinous cystadenocarcinoma (n=1). Overall accuracies for determination of malignancy using QE-EUS, CEH-EUS, their combination, and EUS-guided tissue acquisition were 98.4% (95% confidence interval (CI): 91.4-99.7), 85.5% (95% CI: 74.7-92.2), 91.9% (95% CI: 82.5-96.5), and 91.5% (95% CI: 83.6-99.5), respectively. Conclusion: The combination of QE-EUS and CEH-EUS is a useful tool for the differential diagnosis of SPT, giving complementary information. However, this combination does not significantly increase the diagnostic accuracy of either of the techniques performed alone.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Gastroenterologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Gastroenterology and Hepatology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
Nyckelord
- Solid pancreatic lesion
- stiffness
- vascularization
- tissue acquisition
- endoscopic ultrasound
- endoscopic ultrasound elastography
- fine-needle-aspiration
- focal
- pancreatitis
- lesions
- ultrasonography
- metaanalysis
- adenocarcinoma
- accuracy
- cancer
- discrimination
- Gastroenterology & Hepatology
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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